| Introducing national guidelines on perioperative chemotherapy for gastric cancer in Norway: a retrospective audit. | |
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MedLine Citation:
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PMID: 20627647 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In 2006, perioperative chemotherapy with epirubicin, cisplatin/oxaliplatin, and capecitabine was recommended in the National Guidelines for patients with resectable gastric cancer in Norway. We conducted a national audit related to clinical aspects, local organisation and the implementation of this multimodal treatment. PATIENTS AND METHODS: All Norwegian departments of oncology were asked to submit aggregated data on gastric cancer patients who had started perioperative chemotherapy for cure; departments of surgery were asked to report on patients undergoing resection after preoperative chemotherapy. Data were retrospectively collected. RESULTS: All 20 departments of oncology and 20 of 21 departments of surgery responded. Of 336 patients operated on for gastric cancer and reported by surgeons, 144 (43%) received preoperative chemotherapy. 169 patients were reported by departments of oncology. 152 (90%) completed the preoperative cycles; 92 (54%) started the postoperative cycles; and 68 (40%) completed all cycles. Toxicity grade >or= 3, overall and haematological, increased during postoperative compared to preoperative cycles, 50 vs. 34% (P = 0.012) and 35 vs. 20% (P = 0.012), respectively. Surgical morbidity and mortality were 26 and <2%, respectively. R0 resection was achieved in 86% of surgically treated patients. Five per cent had a complete pathological response (ypT0) and 48% were node negative (ypN0). Within the first year, the National Guidelines were implemented in 19 of 25 hospitals (76%). CONCLUSIONS: In this population-based series, the tolerability of perioperative chemotherapy reported in the MAGIC trial was reproduced. Toxicity grade >or= 3 was considerable and significantly increased related to postoperative cycles. The National Guidelines were rapidly adopted. |
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Authors:
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T Hølmebakk; G Frykholm; A Viste; |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology Volume: 36 ISSN: 1532-2157 ISO Abbreviation: Eur J Surg Oncol Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-15 Completed Date: 2010-07-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8504356 Medline TA: Eur J Surg Oncol Country: England |
Other Details:
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Languages: eng Pagination: 610-6 Citation Subset: IM |
Affiliation:
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Department of Surgical Gastroenterology, Oslo University Hospital, Aker, 0514 Oslo, Norway. toto.holmebakk@oslo-universitetssykehus.no |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
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drug therapy,
surgery Adult Aged Antineoplastic Combined Chemotherapy Protocols / adverse effects, therapeutic use* Carcinoma / drug therapy*, pathology, surgery* Chemotherapy, Adjuvant Female Humans Male Medical Audit Middle Aged Neoadjuvant Therapy / methods Norway Practice Guidelines as Topic Retrospective Studies Stomach Neoplasms / drug therapy*, pathology, surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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